JOURNAL OF THE INDIAN MEDICAL ASSOCIATION, VOL 118, NO 07, JULY 2020
Voice of the Expert COVID 19 Vaccine — Hope & Hype
D
r Ravi Wankhedkar is a name which needs no introduction. A past national president of the IMA (2018), he is a successful practising surgeon of Maharashtra. He is a polymath in all sense of the term, with active involvement in multiple socio-cultural activities. He is particularly involved in medical services among the poor of his home town. The JIMA editorial board discussed various aspects of the current pandemic with Dr Wankhedkar recently. The interview was conducted by Prof Jyotirmoy Pal and final copy editing was done by Dr Rudrajit Paul. The excerpts of that interview are presented here, exclusively for the readers of JIMA.
Dr Wankhedkar, welcome to JIMA. We are honoured to be allowed this privilege of talking with you. First, can you tell us your general thoughts on the current scenario ? Ans : - With no control of the pandemic in sight, desperation and fatigue has set it. All of us feel that a vaccine will be the key to the EXIT strategy to return to normal. This is mostly true. But there are many uncertainties which we all need to understand about vaccines as ‘The ‘ ultimate answer to the current crisis. There are complexities of developing a vaccine at ultra-short notice.An effective vaccine that is too complex to make in bulk, or is difficult to formulate, is highly unstable withoutrefrigeration or freezing, is challenging to administer or that requires too many doses over a prolonged period may represent a Pyrrhic victory for science, but not the answer to the problems faced by the societies that science serves.
Q1 - We know it is very difficult to make predictions. But, still our readers would like to know when will the vaccine be available ? Scientists are surging forward with possible COVID19 vaccines,but they’ve still got a long way to go.In the history of medicine, rarely has a vaccine been developed in less than five years.Enormous amounts of public money and resources poured into vaccine research and development have resulted in more than 150 COVID-19 vaccine candidates, ten of which are now in clinical trials.
The most advanced candidate is AZD1222, first developed by researchers at the University of Oxford. Developing a successful vaccine is hit or miss under any circumstances. And SARS-Cov-2 is a fickle and baffling new virus.If everything goes smoothly you might know as early as start of next year you have a vaccine that’s likely to be effective. Normally safe vaccines take years to develop but thx to modern technology & Augmented Intelligence scientists hope they can now be developed within a year. Indeed, the story of vaccine development is largely the story of failure. Most research efforts end where they begin -in the lab.It can be very difficult to find the weak spot in a virus and how to get the immune system to launch a counter-attack. Many viruses also mutate, making them harder to disable. That’s proven to be particularly true of HIV/AIDS.Some research efforts do produce experimental vaccines, and they often work well in animals. But then they fail in humans.Scientists have a phrase for it: “ Mice lie, monkeys exaggerate “
Editorial note : Vaccine development takes a lot of time. In spite of repeated attempts, vaccines for HIV, dengue or malaria are still elusive. So, only vaccine development should not be the crux of all efforts. We should try other avenues like anti-virals too. during the 1897 plague epidemic of India, the British government touted antiplague vaccine as a cure-all. But the efficacy of that vaccine was doubtful.
Q2 - Will it be effective ? Vaccines induce immunity. What will be the type, effectiveness and duration of this immunity is 34
